Healthcare Provider Details

I. General information

NPI: 1205495660
Provider Name (Legal Business Name): NO NEEDLES CHILDREN'S DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3124 W MAIN ST STE 3
DOTHAN AL
36305-1181
US

IV. Provider business mailing address

3124 W MAIN ST STE 3
DOTHAN AL
36305-1181
US

V. Phone/Fax

Practice location:
  • Phone: 419-599-4216
  • Fax:
Mailing address:
  • Phone: 419-599-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATHAN PFISTER
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 334-446-3888